Individual
RANDLE SCOTT CORFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D, M.D.
Contact information
Practice address
12000 ELM CREEK BLVD N, SUITE 350, MAPLE GROVE, MN 55369-7073
(763) 494-7700
(763) 494-7706
Mailing address
12000 ELM CREEK BLVD N, SUITE 350, MAPLE GROVE, MN 55369-7073
(763) 494-7700
(763) 494-7706
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
207VE0102X
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3D491-MI
BCBS-MN PROVIDER #
MN
01
—
3D492
BCBS-MN PROVIDER NUMBER
FM
01
—
COR16153
BCBS-ND PROVIDER NUMBER
ND
01
—
COR16154
BCBS-ND PROVIDER #
ND
Enumeration date
02/16/2007
Last updated
07/08/2007
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